新冠疫苗接种后发生斑秃：系统评价。
Alopecia areata following COVID-19 vaccine: a systematic review.
机构信息
Department of Dermatology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, 1 Minde Road, Nanchang, 330006, Jiangxi, China.
Department of Plastic Surgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.
出版信息
Eur J Med Res. 2024 Jul 5;29(1):356. doi: 10.1186/s40001-024-01956-8.
BACKGROUND
To date, multiple cases of adverse reactions to COVID-19 vaccines have been reported worldwide. Alopecia areata (AA) is an uncommon type of adverse reaction reported in some articles and has a significant social and psychological impact on patients. Our study aimed to review the AA and COVID-19 vaccine literature.
METHODS
This systematic review was conducted by searching for articles on AA following COVID-19 vaccines in international databases such as Embase, MEDLINE, PubMed, Web of Knowledge, and Ovid from December 2019 to December 30, 2023. We included studies that provided data for AA patients following COVID-19 vaccination with at least one dose. Data on sex, age, country/region of origin, vaccine type, days between vaccination and symptom presentation, manifestations of AA, trichoscopy and histopathological findings, treatment, and outcomes were included.
RESULTS
In total, 579 explored studies were identified and assessed, and 25 articles with a total of 51 patients were included in the review. Twenty-seven (52.9%) patients developed new-onset AA following receiving the COVID-19 vaccine, and AA recurrence or exacerbation occurred after receiving the COVID-19 vaccine in 24 (47.1%) patients with preexisting disease. Five vaccines were reported to cause AA in all cases. The Pfizer vaccine (45.1%) was the most frequently reported, followed by the ChAdOx1 nCoV-19 vaccine (27.5%), Moderna mRNA-1273 (19.6%), Sinopharm (3.9%) and SinoVac (3.9%). AA occurred most frequently within one month after the 1st dose, and then, the incidence decreased gradually with time. Topical or systemic corticosteroids were used in 38 patients. Eleven patients were treated with a Janus Kinase inhibitor (jakinib) inhibitor, eight with tofacitinib, and three with an unspecified jakinib. However, 3 of the 11 patients experienced exacerbations after treatment.
CONCLUSION
AA after COVID-19 vaccination is rare, and physicians should be aware of this phenomenon to improve early diagnosis and appropriate treatment.
背景
迄今为止，全球已报告多例 COVID-19 疫苗不良反应病例。斑秃 (AA) 是一些文章中报道的一种罕见的不良反应类型，对患者有重大的社会和心理影响。我们的研究旨在回顾 AA 和 COVID-19 疫苗的文献。
方法
本系统评价通过在 Embase、MEDLINE、PubMed、Web of Knowledge 和 Ovid 等国际数据库中搜索 COVID-19 疫苗接种后 AA 的文章进行，检索时间为 2019 年 12 月至 2023 年 12 月 30 日。我们纳入了至少接受一剂 COVID-19 疫苗后提供 AA 患者数据的研究。纳入的数据包括性别、年龄、原籍国/地区、疫苗类型、接种疫苗和症状出现之间的天数、AA 的表现、毛发镜和组织病理学发现、治疗和结局。
结果
共发现 579 项探索性研究，并对其中 25 项共 51 例患者的文章进行了综述。27 例（52.9%）患者在接种 COVID-19 疫苗后出现新发 AA，24 例（47.1%）原有疾病患者在接种 COVID-19 疫苗后出现 AA 复发或加重。所有病例均报告了 5 种疫苗导致 AA。最常报告的是辉瑞疫苗（45.1%），其次是 ChAdOx1 nCoV-19 疫苗（27.5%）、Moderna mRNA-1273（19.6%）、国药（3.9%）和科兴（3.9%）。AA 最常发生在第 1 剂后 1 个月内，随后随着时间的推移，发病率逐渐下降。38 例患者使用局部或全身皮质类固醇治疗。11 例患者使用 Janus 激酶抑制剂（jakinib）抑制剂治疗，8 例使用托法替尼，3 例使用未指定的 jakinib 抑制剂。然而，11 例患者中有 3 例在治疗后出现恶化。
结论
COVID-19 疫苗接种后发生 AA 较为罕见，医生应意识到这一现象，以提高早期诊断和适当治疗。
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